Organization
MARIETTA WEST COBB COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI ABRAHAM LPC (CEO)
(770) 591-7518
Entity
Organization
Contact information
Practice address
707 WHITLOCK AVE SW STE H10, MARIETTA, GA 30064-3098
(770) 415-0880
Mailing address
707 WHITLOCK AVE SW, SUITE H-10, MARIETTA, GA 30064-3000
(770) 591-7518
(678) 498-2843
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10063295
AMERIGROUP
GA
01
—
10063297
AMERIGROUP
GA
05
—
129577652A
—
GA
01
—
1427124593
BCBS
GA
01
—
5732533
AETNA
GA
01
—
726881000
MAGELLAN
GA
Enumeration date
05/22/2008
Last updated
02/26/2019
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